Children with asthma who take certain drugs in a powdered form rather than an aerosol are at risk for tooth erosion, according to British researchers. This may be associated with increased gastroesophageal reflux or frequent use of oral drugs. Powdered formulations of asthma medications are more acidic than aerosol versions, and the enamel of teeth may begin to dissolve at a pH of 5.5. Powdered version of asthma drugs such as beclomethasone dipropionate, fluticasone (Flovent), salmeterol , and terbutaline sulphate (Brethair) powders have a pH below this.
As increasing numbers of children are using the powdered form of drugs, doctors should advise children to rinse their mouths with water directly after taking the drugs. Children should also be encouraged to clean their teeth thoroughly at least twice a day with a non- fluoride toothpaste.
British Medical Journal September 19, 1998;317:820.
COMMENT: Just when you think a class of drugs is relatively safe, major side effects become known. I was not aware of this problem prior to this article. It seems every drug has some trade off. Fortunately, these drugs do work quite well and save many people’s lives. However, if one uses inhalers for asthma, it would be wise to brush your teeth or at least rinse your mouth out to prevent your enamel from eroding away. This is a British study and they did not study Maxair and other oral inhalers. My guess is that the same precautions apply for all inhalers, but one can check the PDR or call the company to find out the pH of the drug. If it is below 5.5, it will be a problem.